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Nutritional Status of Children. Measures, Estimates and Explanations. Malnutrition Indicators. Malnutrition indicators: Differ with respect to the stage in one’s life cycle. Intra-uterine Undernutrition: Low Birth Weight (LBW). Cause: Maternal malnutrition: Effect:
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Nutritional Status of Children Measures, Estimates and Explanations
Malnutrition Indicators • Malnutrition indicators: Differ with respect to the stage in one’s life cycle. Nutritional Status of Children
Intra-uterine Undernutrition: Low Birth Weight (LBW) • Cause: Maternal malnutrition: • Effect: • Malnutrition during intra-uterine life. • Retards the growth and development of the foetus during pregnancy. • The foetus is born with birth weight lower than normal. • The cut-off value for birth weight is 2.5 kg(WHO). • Babies born with birth weight <2.5 kg are LBW babies. Nutritional Status of Children
Childhood Malnutrition • Severe consequences if it occurs early in life. • Adverse impact on subsequent growth, morbidity, cognitive development, educational attainment and productivity in adulthood. Nutritional Status of Children
Nutrition status: Children U5 • Anthropometric Indicators: • Height-for-age (HFA), • Weight-for-age (WFA), • Weight-for-height (WFH), and • MUAC-for-age. • Most sensitive indicators of food security, vulnerability and overall socio-economic development of a country. • Stunting, Wasting and Underweight. • Z-score classification. Nutritional Status of Children
Malnutrition Indicators • Measure the clinical phenomena of malnutrition. • Standard cutoff points are used internationally to define under nutrition in children 6-59 months. • The cutoff points for nutrition indicators are derived from the WHO child growth standard population (WHO standards) or NCHS reference population (NCHS population). Nutritional Status of Children
Stunting (low height-for-age) • Cause: Chronic under nutrition retards growth of a child by height. • Stunting: child is shorter for its age. • Information requirement: Estimates of height and age. Nutritional Status of Children
Stunting (low height-for-age) • Low HFA identifies past or chronic under nutrition (stunting) • Stunting indicates reduced linear growth • Cannot measure short-term changes in malnutrition • For children <2 yrs of age, the term is length-for-age/LA • For children > 2 yrs age, the index is referred to as height-for-age/HA Nutritional Status of Children
Stunting: Classification • Height-for-age up to -2SD = Normal • Height-for-age <-2SD to -3SD = Moderate • Height-for-age <-3SD = Severe Nutritional Status of Children
Wasting (low weight–for-height) • Cause: Acute, short-run malnutrition • Affects only body weight. • “Wasting” of the body, i.e. loss of body mass compared to the body size. • Indicator: Weight-for-height. Nutritional Status of Children
Wasting (low weight–for-height) Weight for-height: • Low WFH identifies current or acute under nutrition (wasting) • Useful when exact age is difficult to determine • - Weight for-length (< 2 yrs) or weight for-height (in > 2 yrs) • Appropriate for examining short-term effects Nutritional Status of Children
Wasting: Classification • Normal weight-for-height: If its weight-for-height is within 2 standard deviations (-2SD) of the median weight-for-height of a reference population. • Moderately wasted: If the weight-for-height falls below 2SD (<-2SD) but within 3 SD below the reference median (-3SD). • Severely wasted: If the weight-for-height falls below 3SD of the reference median (<-3SD). Nutritional Status of Children
Wasting: Classification • Weight-for-height up to –2SD = Normal • Weight-for-height <-2SD to –3SD = Moderate • Weight-for-height <-3SD = Severe Nutritional Status of Children
Underweight (low weight-for-age) • Composite indicator of long-term and acute short-term malnutrition. • The body weight may be lost from malnutrition for a long time => low weight-for-age. • Weight may also be lost from acute, short-term malnutrition => low weight-for-age. Nutritional Status of Children
Underweight: Classification • Normal weight-for-age: If weight-for-age is within 2 standard deviations (-2SD) of the median weight-for-age of a reference population. • Moderately underweight: If the weight-for-age falls below 2SD (<-2SD) but within 3 SD below the reference median (-3SD). • Severely underweight: If the weight-for-age falls below 3SD of the reference median (<-3SD). Nutritional Status of Children
Underweight: Classification • Weight-for-age up to -2SD = Normal • Weight-for-age <-2SD to -3SD = Moderate • Weight-for-age <-3SD = Severe Nutritional Status of Children
Mid- Upper Arm Circumference (MUAC) • Low MUAC (<12.5 cm) indicates acute malnutrition among children 6-59 months. • Is relatively easy to measure and a good predictor of immediate risk of death. • Is used for rapid screening of acute malnutrition. Nutritional Status of Children
Food consumption, energy and nutrient intake and nutritional status in rural Bangladesh: Changes from 1981 – 1982 to 1995 – 96 Source: Helset al. (2003)
